Even as federal officials push states to expand Medicaid programs, at least a dozen states are not ready or not willing to set up state-based health exchanges -- another aspect of the health law that is key to expanding insurance coverage.

The New York Times: Administration Advises States To Expand Medicaid Or Risk Losing Federal Money
The Obama administration is putting pressure on states to expand Medicaid, telling them they may lose federal money if they delay. But at the same time, federal health officials have also told states that if they choose to expand Medicaid, they are free to reverse the decision at any time (Pear, 10/2).

The Washington Post: Many States Not Prepared For Health-Care Law
More than three dozen states could be unprepared or unwilling to set up the insurance marketplaces called for under the 2010 health-care law, leaving at least part of the task up to the federal government, according to a new report. But many of the rest of the states are behind in their planning or have decided not to operate exchanges on their own, according to a report from the Health Research Institute (Somashekhar, 10/2).

Politico Pro: EHB Drug Coverage Bests ACA Minimums So Far
Patient advocates and House Democrats have complained the skimpy one-drug-per-class standard HHS pitched in December's EHB bulletin falls short of the Affordable Care Act's promise for comprehensive coverage. But an Avalere analysis of eight of the plans already submitted to HHS showed that states' benchmarks cover a much broader scope of drugs than the administration's minimum requirement (Millman, 10/1).

The Associated Press/Register-Herald: W. Va. Questions HHS On Essential Benefits
West Virginia officials are questioning another major provision of the federal health care overhaul, this one calling on states to set basic levels for 10 categories of services that many insurance policies must cover. Gov. Earl Ray Tomblin wrote U.S. Health and Human Services Secretary Kathleen Sebelius on Friday, posing seven questions regarding benchmarks for essential health benefits (Messina, 10/1).

California Healthline: Millions Will Fall Though ACA Cracks In California, Report Predicts
As many as four million Californians could remain uninsured after all national health reforms are in place, and about half of them will be eligible for subsidized coverage but not enrolled, according to a new report. National reform will bring health coverage to millions of previously uninsured Californians through the expansion of Medi-Cal and creation of subsidized insurance through the new Health Benefit Exchange. However, millions still will fall through the cracks, say authors of a joint report from the UC-Berkeley Center for Labor Research and Education and the UCLA Center for Health Policy Research (Lauer, 10/1).

St. Louis Beacon: At Issue: Two Years After ACA Becomes Law, Debate Over Costs And Responsibility Continues
[The] ACA hasn't been popular in Missouri. On August of 2010, voters across the state gave strong support to Proposition C, in effect repudiating a federal mandate that people buy health insurance or be fined. ...Two sessions ago, a bill to set up an affordable insurance exchange won bipartisan approval in the Missouri House. But the measure never came up for a vote in the Senate. In November, voters will have a chance to have their say once again on the exchange issue (Joiner, 10/1).

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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